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On-Study - Metastatic Brain Cancer - On-Study Form - 2287553v3.0 - Metastatic Brain Cancer - On-Study Form

- 1/9/15 - 1 form, 10 itemgroups, 64 items, 1 language
Itemgroups: CRF Header, Brain: Form Administration, Non-CNS: Initial Disease Description, Brain: Current Disease Description, Brain: Concomitant Medications, Metastatic Brain: Prior Health History, Metastatic Brain: Prior Treatment, Brain: Prior Treatment - Systemic Regimens, Brain: Prior Treatment - CNS RT, Brain: Prior Treatment - CNS Surgery
Metastatic Brain Cancer - On-Study Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=EF3A8ACE-5457-4C56-E034-0003BA3F9857

On-Study - Primary Brain Cancer - On-Study Form Recurrent Treatment - 2293986v3.0 - Primary Brain Cancer - On-Study Form Recurrent Treatment

- 1/9/15 - 1 form, 9 itemgroups, 62 items, 1 language
Itemgroups: CRF Header, Brain: Form Administration, Brain: Recurrent Disease Description, Brain: Neurologic Function, Brain: Concomitant Medications, Brain: Prior Health History, Brain: Prior Treatment, Brain: Prior Treatment - Systemic Regimens, Comments
Primary Brain Cancer - On-Study Form Recurrent Treatment Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E51DA7FB-264B-3B94-E034-0003BA3F9857

On-Study - Primary Brain Cancer - On-Study Form Newly Diagnosed Patients - 2293729v3.0 - Primary Brain Cancer - On-Study Form Newly Diagnosed Patients

- 1/9/15 - 1 form, 7 itemgroups, 45 items, 1 language
Itemgroups: CRF Header, Brain: Form Administration, Brain: Disease Description, Brain: Neurologic Function, Brain: Prior Health History, Brain: Concomitant Medications, Brain: Prior Surgical Treatment for Primary Site
Primary Brain Cancer - On-Study Form Newly Diagnosed Patients Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=E51E77B9-7E48-3A03-E034-0003BA3F9857

Brain and Central Nervous System Tumors NCT00884741 On-Study - RTOG 0825: QOL M.D. Anderson Symptom Inventory - 2800871v1.0 - RTOG 0825: QOL M.D. Anderson Symptom Inventory

- 9/20/21 - 1 form, 4 itemgroups, 50 items, 1 language
Itemgroups: Header Module, QOL Cover Sheet, Part I. M.D. Anderson Symptom Inventory (MDASI-BT), Part II
RTOG 0825: QOL M.D. Anderson Symptom Inventory Temozolomide and Radiation Therapy With or Without Bevacizumab in Treating Patients With Newly Diagnosed Glioblastoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5BABD9A9-3DF8-0152-E044-0003BA3F9857

HIV Cancer Sunitinib NCT00890747 AMC-061 - Protocol Deviation Form (DEV)

- 6/12/17 - 1 form, 2 itemgroups, 10 items, 1 language
Itemgroups: Header Module, Protocol Deviation
AMC-061 Protocol Deviation Form (DEV) Sunitinib Malate in Treating HIV-Positive Patients With Cancer Receiving Antiretroviral Therapy https://clinicaltrials.gov/ct2/show/NCT00890747

HIV Cancer Sunitinib NCT00890747 AMC-061 - Missed Visit Form (F35)

- 6/12/17 - 1 form, 2 itemgroups, 6 items, 1 language
Itemgroups: Header Module, Missed Visit Information
AMC-061 Missed Visit Form (F35) Sunitinib Malate in Treating HIV-Positive Patients With Cancer Undergoing Highly Active Antiretroviral Therapy https://clinicaltrials.gov/ct2/show/NCT00890747

RTOG 0825 Phase III GBM Initial Evaluation Form (I1)

- 8/4/15 - 1 form, 10 itemgroups, 86 items, 1 language
Itemgroups: Header Module, General Information, DISEASE INFORMATION, PRE-STUDY SCANS, PRE-STUDY SCANS1, LOCATION OF PRIMARY, Baseline Lab Values, Systemic Treatment, SEVERE ACTIVE COMORBIDITY, Footer Module
RTOG 0825 Phase III GBM Initial Evaluation Form (I1) Temozolomide and Radiation Therapy With or Without Bevacizumab in Treating Patients With Newly Diagnosed Glioblastoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5AE2A23C-8AD1-6A8B-E044-0003BA3F9857

RTOG 0834: Medical Outcome Scale: Cognitive NCT00626990

- 7/8/15 - 1 form, 3 itemgroups, 29 items, 1 language
Itemgroups: RTOG clinical trial administrative data, Various questionnaire related information, Cognition Quality of Life
RTOG 0834/EORTC 26053_22054/NCIC CTG CEC.1: Medical Outcome Scale: Cognitive NCT00626990 Radiation Therapy With or Without Temozolomide in Treating Patients With Anaplastic Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=5AF816A5-3103-0942-E044-0003BA3F9857

ADVL0212: On Study Worksheet [reload] NCT00053963

- 7/5/15 - 1 form, 7 itemgroups, 42 items, 1 language
Itemgroups: Header, Treatment related information, Diagnosis, Hemogram, Chemistries, Comments, CCRR MODULE
ADVL0212: On Study Worksheet [reload] NCT00053963 FR901228 in Treating Children With Refractory or Recurrent Solid Tumors or Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=B304C5F5-C7EC-0452-E034-0003BA12F5E7

ADVL0212: Pre-Existing Conditions At Time of Study Entry NCT00053963

- 7/5/15 - 1 form, 4 itemgroups, 14 items, 1 language
Itemgroups: Header, Adverse event assessment, Comments, CCRR MODULE
ADVL0212: Pre-Existing Conditions At Time of Study Entry NCT00053963 FR901228 in Treating Children With Refractory or Recurrent Solid Tumors or Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BB5F4F72-BF42-1043-E034-0003BA12F5E7

E3F05 Brain On-Study Form NCT00978458

- 6/16/15 - 1 form, 8 itemgroups, 43 items, 1 language
Itemgroups: Header Module, Patient demographics, Data amendment, Patient Description Pre-Registration Hematology/Chemistry, Prior Brain Surgery, Motivation for Study Entry, Adverse Events present at time of registration (pre-treatment), Comments
E3F05 Brain On-Study Form NCT00978458 Radiation Therapy With or Without Temozolomide in Treating Patients With Low-Grade Glioma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=6C76FF0A-A556-4EDB-E040-BB89AD4325FA

Brain and Central Nervous System Tumors NCT00890747 On-Study - AMC-061 On Study Form (F02) - 2935131v1.0 - AMC-061 On Study Form (F02)

- 1/9/15 - 1 form, 6 itemgroups, 46 items, 1 language
Itemgroups: Header Module, HIV History, History of Malignancy for study, HIstory of Other Malignancy, Antiretroviral Therapy, Comments
AMC-061 On Study Form (F02) Sunitinib Malate in Treating HIV-Positive Patients With Cancer Undergoing Highly Active Antiretroviral Therapy Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=71988CF7-F9B0-68F0-E040-BB89AD4358A1

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